Provider Demographics
NPI:1356503908
Name:CAMELOT LLC
Entity Type:Organization
Organization Name:CAMELOT LLC
Other - Org Name:CAMELOT CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FOUNDER, THERAPIST, EDUCATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MICHAL
Authorized Official - Middle Name:
Authorized Official - Last Name:RINKEVICH
Authorized Official - Suffix:
Authorized Official - Credentials:BS, CMT
Authorized Official - Phone:650-949-3332
Mailing Address - Street 1:1000 FREMONT AVE
Mailing Address - Street 2:SUITE 155
Mailing Address - City:LOS ALTOS
Mailing Address - State:CA
Mailing Address - Zip Code:94024-6093
Mailing Address - Country:US
Mailing Address - Phone:650-949-3332
Mailing Address - Fax:
Practice Address - Street 1:1000 FREMONT AVE
Practice Address - Street 2:SUITE 155
Practice Address - City:LOS ALTOS
Practice Address - State:CA
Practice Address - Zip Code:94024-6093
Practice Address - Country:US
Practice Address - Phone:650-949-3332
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-25
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Single Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
No173C00000XOther Service ProvidersReflexologistGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty